NPI | 1700420346 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1177438) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN11004860) |
163W00000X Registered Nurse (Licence: PA RN782149) | |
163WP0200X Registered Nurse, Pediatrics (Licence: FL 11004860) | |
Enumeration Date | 2019-11-06 |
Last Update Date | 2025-09-29 |